Asking about suicide does not plant the idea — this has been studied repeatedly, and avoidance is what does harm. Work through three stages with one person: choose the words you would actually say, climb the whole ladder from ideation to plan to intent to access to preparatory acts, and then build a written safety plan. Watch the acuity readout on the right change with every answer he gives you.
How do you ask?Mr J, 54, admitted after a relationship breakdown. One previous non-fatal attempt two years ago.
He has just said
“There is no point in any of this. I have not slept properly since she left.”
You are sitting at an angle, the door is clear, the room is private and you have twenty minutes. This is the moment the screen belongs in.
Climb the whole ladderAsk each rung and read what he says. Do not stop early because an answer sounded reassuring.
Build the plan with him, not for himSix of these belong in a safety plan. Six do not. Choose each one and find out which.
Language discipline
A person dies by suicide; nobody “commits” it — committing is what one does with a crime. An attempt is fatal or non-fatal, never “successful” or “failed,” and never a “gesture.” Low-lethality attempts are strongly associated with later fatal ones, and dismissing them has cost lives. Toxicology screens are positive or negative, not “clean” or “dirty.” A person is not “a schizophrenic” or “an addict” but a person living with schizophrenia, a person with a substance use disorder. Nobody is “committed” by a nurse either — the term is involuntary admission, a legal process with criteria, review and a right of appeal.
What that just changed
Start with the wordingEvery option is explained whichever one you choose. The euphemisms are the ones that get used in practice, so it is worth understanding exactly what they cost rather than simply avoiding them.
Acuity, as it stands
Not yet screened
0 of 7 rungs asked
A denial is not a clearance. People who have decided often deny ideation, particularly when they feel calm about the decision. A sudden unexplained lift in mood after weeks of severe depression, giving away possessions, or a person who becomes settled and organised after a long period of anguish should raise your concern rather than lower it.
The safety plan
Not a contract. There is no evidence that no-suicide or “contract for safety” documents reduce suicide, they carry no legal protection, they suppress honest disclosure because the person does not want to disappoint you, and they falsely reassure staff. What replaces them: the written collaborative plan above, lethal-means restriction, a prescribed observation level, and a follow-up appointment that is actually booked.